{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T10:49:55Z","timestamp":1783334995780,"version":"3.54.6"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Viral Hepatitis"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>It is well described in current literature that Hepatitis B virus (HBV) affects Asian Americans more than any other racial group in the United States and that there is a stigma attached to this condition. The effects of stigma can be lasting, penetrating physiologically and psychologically, yet few studies have focused on the consequences of this phenomenon. The purpose of this study was to examine the mediating role of stigma in the effect of racial discrimination and knowledge (of HBV sequelae) on health status of Korean Americans with chronic hepatitis B (CHB). Three hundred sixty\u2010five CHB patients were recruited and enrolled from two clinics in Philadelphia and Los Angeles. Depressive symptoms were measured using the Patient Health Question\u20109 (PHQ\u20109), physical health via self\u2010rated health survey and stigma via hepatitis B quality of life (HBQOL)\u2014stigma survey. Perceived racial discrimination and knowledge of CHB sequelae were independent variables. The cohort had an average age of 60.1\u2009years (range 19\u201384, SD 10.7), 56% were male and 94% were born in South Korea. Mediational analysis found that stigma was a significant mediator between both racial discrimination (indirect effect\u2009=\u2009.037, Bootstrap 95% CI\u2009=\u2009[.010\u2013.064]) and sequelae knowledge (indirect effect\u2009=\u2009.097, Bootstrap 95% CI\u2009=\u2009[.018\u2013.176]) and depressive symptoms. Stigma also had a direct effect on depressive symptoms (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009.136, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.01) and self\u2010rated health (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009.018, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). In addition, age, gender, education and employment were related to health outcomes. The findings of this study indicate that HBV\u2010related stigma is an important mediator of mental health outcomes in this population. Future studies should identify other psychosocial factors to develop effective intervention programs to reduce stigma and improve quality of life among CHB patients.<\/jats:p>","DOI":"10.1111\/jvh.13932","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T05:23:29Z","timestamp":1709011409000},"page":"248-254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Racial discrimination, knowledge, and health outcomes: The mediating role of hepatitis B\u2010related stigma among patients with chronic hepatitis B"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8056-5011","authenticated-orcid":false,"given":"Julia G.","family":"Katcher","sequence":"first","affiliation":[{"name":"Sidney Kimmel Medical College Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann C.","family":"Klassen","sequence":"additional","affiliation":[{"name":"Dornsife School of Public Health Drexel University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hie\u2010Won","family":"Hann","sequence":"additional","affiliation":[{"name":"Liver Disease Prevention Center Thomas Jefferson University Hospital  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi","family":"Chang","sequence":"additional","affiliation":[{"name":"Asian Pacific Liver Center, Coalition of Inclusive Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7837-7009","authenticated-orcid":false,"given":"Hee\u2010Soon","family":"Juon","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"Fast Facts on Global Hepatitis B [Internet]. 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